Education and Services for People with Autism Limited - 7 The Cedars

Education and Services for People with Autism Limited - 7 The Cedars is a residential service for up to seven people with autism spectrum condition. The accommodation for six people is within a large detached house and the seventh place is within a separate converted coach house in the grounds. At the time of this visit there were seven people using the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. The home was well personalised, with no obvious signage indicating it was a care home. The feel of the service was homely, relaxed and determined by people’s needs.

People’s experience of using this service and what we found

The service had a pioneering and holistic approach to assessing and acting on people’s needs. Staff worked exceptionally well with external health and social care professionals to ensure people could access healthcare. People enjoyed a range of significantly improved health and wellbeing outcomes thanks to the service’s approach to health screening, reasonable adjustments and incorporating of best practice into processes and training.

Adaptations to the service were innovative, person-centred and had a demonstrable impact on people’s wellbeing and ability to act independently.

People were safe. Staff supported people positively to reduce anxieties, agitation and to empower people to take part in positive activities. Risk assessments were comprehensive and person-centred.

Staff were knowledgeable regarding medicines and worked closely with external specialists.

Staffing levels were safe. Premises were well maintained and clean.

Relatives and external healthcare professionals were confident in staff and their ability to keep people safe.

Incidents, accidents and safeguarding matters were documented and analysed. Staff understood their safeguarding responsibilities and were well supported and trained by the provider.

Staff received excellent training and support, including bespoke additional training from the registered manager.

People's needs were comprehensively assessed and regularly reviewed. Staff had a sound understanding of people’s communication needs.

Activities were geared towards people’s interests and had regard to people’s aspirations. The provider’s day centre was nearby and there were strong community links in place.

People’s rooms were well personalised. Communal areas and outdoor spaces offered people a range of options.

Staff interacted with people affectionately and with appropriate humour; people were comfortable with staff who they had got to know over several years in some cases.

Relatives, external health and social care professionals and staff though the service was well-managed. There were clear quality assurance and auditing processes in place. The registered manager continually sought ways to improve the service with a view to improving health and wellbeing outcomes for people.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 13 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People actively sought out staff to spend time with and appeared comfortable in their presence. Relatives said the service was very safe for people. There had been few occasions where the service had made safeguarding referrals to protect the people who lived there. Staff were regularly trained in safeguarding processes. The local authority told us that the service took appropriate action to deal with these.

There were enough staff to support the seven people both in the house and out in the community at leisure events. The organisation vetted potential new staff to make sure they were suitable to work with people. Staff were trained in medicines management and supported people with their medicines in a safe way.

Staff felt well-trained and supported to carry out their roles competently. The cook was knowledgeable about people’s individual nutritional needs and also supported people towards greater independent cooking skills where possible.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible; the policies and systems in the service supported this practice. All staff were trained in how to support people when they are agitated or upset. This involved the least physical or restrictive intervention.

Relatives said staff were “genuinely very caring” and went beyond the call of duty. Staff supported people in a friendly and encouraging way that promoted their decision-making skills. Staff were skilled at understanding and respected people’s individual communication methods.

Staff understood each person and supported them in a way that met their specific needs. Each person had a range of social and vocational activities they could take part in if they chose.

The registered manager had worked at the service for several years. They were passionate about the continuous development of the service for the people who lived there. Staff said the management team were open and approachable. They felt very well supported by the management team and by the organisation.

The provider had effective quality assurance processes that included checks of the quality and safety of the service.

Further information is in the detailed findings below.

We found that people's needs were assessed and reviewed and their health and wellbeing was monitored and supported. People were supported to take part in activities that they liked. The service also had arrangements for dealing with emergencies.

We found that the people who were using the service were protected from abuse as the provider had procedures in place for the staff to follow if they suspected anyone was at risk of abuse.

We found that the provider has taken steps to provide care in an environment that was suitably designed and adequately maintained.

There had been no complaints about the service in the past year and procedures were in place to obtain people's views.

We found that some records, which the provider is required to keep, to protect the peoples' safety and wellbeing, were being stored securely and could be located promptly when needed. For example, the care records were kept in secure cabinets.

During the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people were clean and well groomed.